Provider Demographics
NPI:1922597988
Name:SMENTKOWSKI, ROSEMARY E (APN)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:E
Last Name:SMENTKOWSKI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:E
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:1518 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4962
Mailing Address - Country:US
Mailing Address - Phone:732-614-2883
Mailing Address - Fax:
Practice Address - Street 1:1518 4TH AVE
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712
Practice Address - Country:US
Practice Address - Phone:732-614-2883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-05
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00822200363LP0808X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health